Estradiol and testosterone concentrations in follicular fluid as criteria to discriminate between mature and immature oocytes

Abstract

The objective of the present study was to examine the association between follicular fluid (FF) steroid concentration and oocyte maturity and fertilization rates. Seventeen infertile patients were submitted to ovulation induction with urinary human follicle-stimulating hormone, human menopausal gonadotropin and human chorionic gonadotropin (hCG). A total of 107 follicles were aspirated after hCG administration, the oocytes were analyzed for maturity and 81 of them were incubated and inseminated in vitro. Progesterone, estradiol (E2), estrone, androstenedione, and testosterone were measured in the FF. E2 and testosterone levels were significantly higher in FF containing immature oocytes (median = 618.2 and 16 ng/ml, respectively) than in FF containing mature oocytes (median = 368 and 5.7 ng/ml, respectively; P < 0.05). Progesterone, androstenedione and estrone levels were not significantly different between mature and immature oocytes. The application of the receiver-operating characteristic curve statistical approach to determine the best cut-off point for the discrimination between mature and immature oocytes indicated levels of 505.8 ng/ml for E2 (81.0% sensitivity and 81.8% specificity) and of 10.4 ng/ ml for testosterone (90.9% sensitivity and 82.4% specificity). Follicular diameter was associated negatively with E2 and testosterone levels in FF. There was a significant increase in progesterone/testosterone, progesterone/E2 and E2/testosterone ratios in FF containing mature oocytes, suggesting a reduction in conversion of C21 to C19, but not in aromatase activity. The overall fertility rate was 61% but there was no correlation between the steroid levels or their ratios and the fertilization rates. E2 and testosterone levels in FF may be used as a predictive parameter of oocyte maturity, but not for the in vitro fertilization rate.

A Study of Serum and Follicular Fluid C. Reactive Protein and Antisperm Antibody as Predictive Markers for Human Oocyte and Embryo Quality and Icsi Outcome.

“…Successful outcome is associated with a relative small increment in CRP 16 in addition to its effect on the quality and maturity degree of oocyte. Therefore FF content of CRP is believed to be related to fertilization, embryo development and implantation rate 17 .…”

Piroxicam y cambios ováricos de cabras adultas

“…La producción de P4 puede relacionarse con el inicio de luteinización que sucede en algunas especies poco antes de la ovulación o aproximadamente 36 horas después del pico preovulatorio de LH (Costa et al, 2004(Costa et al, , 1752. Si se considera que las cabras recientemente se habían expuesto a un dispositivo intravaginal de liberación de P4; lo cual, también sería causal de elevación de esta hormona.…”

Endometriosis and Infertility: The Role of Oxidative Stress

“…However, the proportions and timing of their production are crucial. It is known that FSH and also LH have hormonal receptors on granulosa cells and there is a synergism between these receptors and intra-follicle hormonal production to permit the development of a follicle that holds a mature oocyte (Costa et al, 2004;Speroff & Fritz, 2005;Silva et al, 2008). Androgens, for instance, are necessary at low concentrations at the very beginning of follicle development, as a substrate for estradiol production.…”

“…Regarding maturation, Costa et al (2004) analyzed cycles stimulated with exogenous gonadotropins without using a GnRH analogue and found that the follicles that held mature oocytes presented an increase in the progesterone/testosterone (P/T) ratio), in the progesterone/estradiol (P/E2) ratio and in the estradiol/testosterone (E/T) ratio in follicular fluid when compared to immature oocytes, suggesting a decrease in C21 to C19 conversion, but not in aromatase activity. Silva et al (2008) analyzed these same ratios in follicles of women submitted to stimulated cycles using a GnRH analogue and observed that the action of the analogue remained intact and its most important effect was a decrease in intra-follicle androgen, with higher rates of fertilization and maturation.…”